Gout in the Foot

What is gout or gouty arthritis?

• Gout is a type of arthritis where crystals of sodium urate form inside and around your joints causing acute inflammation.
• Gout commonly affects the big toe joint, however it can also affect other joints such as the ankles and knees
• Gout may recurr frequently

What causes gouty arthritis?

• Gout is caused by the build-up of excessive uric acid in the blood.
• Uric acid is a waste product of the body and is normaly excreted via the kidneys.
• Excessive production or decreased excretion of uric acid, via urine, leaves too much uric acid in the blood leading to the build-up of sodium urate crystals.
• These crystal could be deposited over the joint cartilage causing acute inflammation.

Who is at high risk of gout?

• Family history: having close relatives with gout (gout often runs in families)
• Lifestyle: being overweight or having high blood pressure or diabetes increases the risk
• Age: The risk of gout increases as we get older
• Kidney disease: Gout is three to four times more likely in men having long-term kidney problems that reduces the elimination of uric acid
• Diet: A purine rich diet may also cause increased uric acid e.g. frequently eating sardines and liver
• Alcohol: drinking too much beer or spirits also increases the risk as they contain relatively high levels of purines

What are the signs and symptoms?

• Severe pain, redness and swelling in a joint and surrounding soft tissue
• Usually develops in a few hours without any known injury.
• The big toe becomes very painful even with light touch
• Commonly affects the big toe but can affect other joints.
• Pain usually resolves within a few days but recurrent flare-ups are not uncommon. However, some people may not get another attack for years.

How do I manage this problem?

• Anti-inflammatory tablets can help with the pain and inflammation.
• A healthier lifestyle and a balanced diet can help control gout attacks

What other treatments are available?

Your GP may consider prescribing Allopurinol or Colchicine if required.
A blood test and/or fluid aspirate from a swollen joint may be performed to check for crystalline rate deposits.
A steroid injection may be recommended if symptoms remain severe and do not settle.